Evaluation of comprehensive care for older adults in primary care services
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/165861 |
Resumo: | OBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care. |
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Evaluation of comprehensive care for older adults in primary care servicesAvaliação da atenção integral ao idoso em serviços de atenção primáriaHealth Services for Older AdultsComprehensive Health CarePrimary Health CareHealth Services ResearchBrazilian Unified Health SystemServiços de Saúde para IdososAssistência Integral à SaúdeAtenção Primária à SaúdePesquisa sobre Serviços de SaúdeSistema Único de SaúdeOBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.OBJETIVO: Avaliar o desempenho da atenção integral ao idoso em serviços de atenção primária do Sistema Único de Saúde no estado de São Paulo, Brasil. MÉTODOS: Um total de 157 serviços de atenção primária de cinco regiões de saúde do centro-oeste paulista respondeu, de outubro a dezembro de 2014, o instrumento pré-validado Questionário de Avaliação e Monitoramento de Serviços de Atenção Básica 2014. Foram selecionadas 155 questões, com base nas políticas e diretrizes nacionais sobre essa temática. As respostas indicam o desempenho do serviço na atenção ao idoso, agrupadas em três domínios de análise: atenção à saúde para o envelhecimento ativo e saudável (45 indicadores, d1), atenção às doenças crônicas não transmissíveis (89 indicadores, d2) e rede de apoio na atenção ao envelhecimento (21 indicadores, d3). A medida de desempenho foi a soma de respostas positivas (valor 1) ou negativas (valor 0) para cada indicador. Os serviços foram agrupados segundo k-médias dos escores de desempenho de cada um dos domínios. Após a ponderação dos domínios (testes Z), foram estimadas as associações entre os escores de cada domínio e variáveis independentes de gestão (tipologia, planejamento e avaliação dos serviços), por meio de regressão linear simples e múltipla. RESULTADOS: A atenção às doenças crônicas não transmissíveis (d2) mostrou, para todos os agrupamentos, melhor desempenho médio (55,7) do que os domínios d1 (35,4) e d3 (39,2). O desempenho do serviço na área geral de planejamento e avaliação esteve associado ao desempenho da atenção ao idoso. CONCLUSÕES: Os serviços avaliados apresentaram implementação incipiente da atenção integral ao idoso. O quadro avaliativo pode contribuir para processos de melhoria da qualidade da atenção primária à saúde.Universidade de São Paulo. Faculdade de Saúde Pública2020-01-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rsp/article/view/16586110.11606/s1518-8787.2020054001370Revista de Saúde Pública; Vol. 54 (2020); 6Revista de Saúde Pública; Vol. 54 (2020); 6Revista de Saúde Pública; v. 54 (2020); 61518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/165861/158741https://www.revistas.usp.br/rsp/article/view/165861/158742https://www.revistas.usp.br/rsp/article/view/165861/158743Copyright (c) 2020 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessPlacideli, NádiaCastanheira, Elen Rose LodeiroDias, AdrianoSilva, Pedro Alcântara daCarrapato, Josiane Lozigia FernandesSanine, Patricia RodriguesMachado, Dinair FerreiraMendonça, Carolina SiqueiraZarili, Thais Fernanda TortorelliNunes, Luceime OliviaMonti, José Fernando CasquelHartz, Zulmira Maria de AraújoNemes, Maria Ines Battistella2020-02-03T02:11:44Zoai:revistas.usp.br:article/165861Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2020-02-03T02:11:44Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Evaluation of comprehensive care for older adults in primary care services Avaliação da atenção integral ao idoso em serviços de atenção primária |
title |
Evaluation of comprehensive care for older adults in primary care services |
spellingShingle |
Evaluation of comprehensive care for older adults in primary care services Placideli, Nádia Health Services for Older Adults Comprehensive Health Care Primary Health Care Health Services Research Brazilian Unified Health System Serviços de Saúde para Idosos Assistência Integral à Saúde Atenção Primária à Saúde Pesquisa sobre Serviços de Saúde Sistema Único de Saúde |
title_short |
Evaluation of comprehensive care for older adults in primary care services |
title_full |
Evaluation of comprehensive care for older adults in primary care services |
title_fullStr |
Evaluation of comprehensive care for older adults in primary care services |
title_full_unstemmed |
Evaluation of comprehensive care for older adults in primary care services |
title_sort |
Evaluation of comprehensive care for older adults in primary care services |
author |
Placideli, Nádia |
author_facet |
Placideli, Nádia Castanheira, Elen Rose Lodeiro Dias, Adriano Silva, Pedro Alcântara da Carrapato, Josiane Lozigia Fernandes Sanine, Patricia Rodrigues Machado, Dinair Ferreira Mendonça, Carolina Siqueira Zarili, Thais Fernanda Tortorelli Nunes, Luceime Olivia Monti, José Fernando Casquel Hartz, Zulmira Maria de Araújo Nemes, Maria Ines Battistella |
author_role |
author |
author2 |
Castanheira, Elen Rose Lodeiro Dias, Adriano Silva, Pedro Alcântara da Carrapato, Josiane Lozigia Fernandes Sanine, Patricia Rodrigues Machado, Dinair Ferreira Mendonça, Carolina Siqueira Zarili, Thais Fernanda Tortorelli Nunes, Luceime Olivia Monti, José Fernando Casquel Hartz, Zulmira Maria de Araújo Nemes, Maria Ines Battistella |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Placideli, Nádia Castanheira, Elen Rose Lodeiro Dias, Adriano Silva, Pedro Alcântara da Carrapato, Josiane Lozigia Fernandes Sanine, Patricia Rodrigues Machado, Dinair Ferreira Mendonça, Carolina Siqueira Zarili, Thais Fernanda Tortorelli Nunes, Luceime Olivia Monti, José Fernando Casquel Hartz, Zulmira Maria de Araújo Nemes, Maria Ines Battistella |
dc.subject.por.fl_str_mv |
Health Services for Older Adults Comprehensive Health Care Primary Health Care Health Services Research Brazilian Unified Health System Serviços de Saúde para Idosos Assistência Integral à Saúde Atenção Primária à Saúde Pesquisa sobre Serviços de Saúde Sistema Único de Saúde |
topic |
Health Services for Older Adults Comprehensive Health Care Primary Health Care Health Services Research Brazilian Unified Health System Serviços de Saúde para Idosos Assistência Integral à Saúde Atenção Primária à Saúde Pesquisa sobre Serviços de Saúde Sistema Único de Saúde |
description |
OBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-01-21 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/165861 10.11606/s1518-8787.2020054001370 |
url |
https://www.revistas.usp.br/rsp/article/view/165861 |
identifier_str_mv |
10.11606/s1518-8787.2020054001370 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/165861/158741 https://www.revistas.usp.br/rsp/article/view/165861/158742 https://www.revistas.usp.br/rsp/article/view/165861/158743 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 54 (2020); 6 Revista de Saúde Pública; Vol. 54 (2020); 6 Revista de Saúde Pública; v. 54 (2020); 6 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221801195765760 |